Elsevier

Social Science & Medicine

Volume 62, Issue 1, January 2006, Pages 217-227
Social Science & Medicine

Alcohol use and sexual behaviour among risky drinkers and bar and shebeen patrons in Gauteng province, South Africa

https://doi.org/10.1016/j.socscimed.2005.05.031Get rights and content

Abstract

This paper describes the South Africa component of a World Health Organization multi-site rapid assessment and response project seeking to develop a methodology for studying factors associated with alcohol use-related sexual risk behaviour in diverse cultural settings. This report focuses on the qualitative assessments that were conducted in order to profile alcohol use and sexual behaviour in the communities concerned, ascertain the relationships between alcohol use and sexual behaviour, and develop a conceptual model of the relationships between alcohol use and sexual risk behaviour. The participants consisted of adults aged between 25 and 44 years in a township and city site in Gauteng province. The assessments involved conducting 18 key informant interviews, observations in seven drinking venues, six focus groups and 16 in-depth interviews of ‘risky drinkers’ and their partners. Most participants felt that there were high levels of alcohol consumption and unprotected sex among some members of their communities, with the latter occurring mainly among casual sexual partners. The findings also pointed to strong links between alcohol consumption and sexual risk behaviour. A conceptual model of the association between alcohol use and risky sexual behaviour is proposed. This study suggests a need for multi-faceted HIV intervention strategies for reducing levels of alcohol abuse in general, and enhancing protective sexual behaviours among alcohol-using populations.

Section snippets

Overview

The two study sites in Gauteng province were a township area just outside the limits of a city, and a suburb within the boundaries of the city. The city site's inhabitants were racially and socio-economically diverse and consisted of just over 25,000 people in 2001, many of whom were unmarried and students of tertiary institutions (Veli Mahlangu, Statistics South Africa, pers. comm.). The site had as many as 250 liquor outlets in 2002 (South African Police Services, pers. comm.) and its few

Results

The findings of the four assessments are combined in order to present a global picture of participants’ perceptions of alcohol use, sexuality, and the relationships between alcohol use and sexual risk behaviour. Gender and study site comparisons are highlighted where evident. There were few differences between the accounts of the ‘risky drinkers’ and partners of ‘risky drinkers’ since most of the latter participants were in fact also ‘risky drinkers’. Direct quotations from the focus groups and

Discussion

This study extends previous research conducted in Africa that has linked alcohol use and sexual risk behaviour (Mnyika et al., 1997; Trigg et al., 1997). This research complements qualitative studies conducted in Zimbabwe (Fritz et al., 2002; Mataure et al., 2002) and helps to further understanding of the relationships.

A number of gender differences in the participants’ responses and observed behaviours were in evidence. Men's drinking was reportedly often for pleasure, recreational and

Acknowledgements

This research was conducted with financial and technical support from the WHO's Department of Mental Health and Substance Abuse. We gratefully acknowledge the participation of the members of the Community Advisory Board, and the translators and fieldworkers (William Dichaba, James Mabaso, Nthabiseng Makhudu, Moira Masipa, Tebogo Molebatsi, Helen Moshia, Helen Moshoeu, Mandla Msibi, Mavis Nkgapele, Mina Ramashala and Albert Shibambo).

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